UK retirees in EU states to lose NHS cover in no-deal Brexit

Pensioner can get treatment reimbursed under EU-wide reciprocal arrangements

Many pensioners retire to Costa del Sol in Spain in order to make ends meet. File photograph: iStock/Getty Images

Many pensioners retire to Costa del Sol in Spain in order to make ends meet. File photograph: iStock/Getty Images


British nationals who have retired to EU countries including Spain and France will no longer have their healthcare covered by the NHS in the event of a no-deal Brexit, the UK government has said.

The confirmation will come as a blow to about 190,000 British citizens retired in the EU in the Spanish Costas, Provence in France and Tuscany in Italy, all popular with British pensioners.

It could also add to the burden on the NHS if pensioners believe they have no option but to return to the UK as the government has previously admitted it is cheaper to pay Spain and France to look after Britons’ medical bills than have them fly home.

Currently, pensioners can get treatment reimbursed by the NHS under an EU-wide body of reciprocal arrangements.

“It is another example of how those advocating ‘no deal’ are playing with the lives of British citizens living in other EU countries,” said Colin Yeo, an immigration lawyer and freedom of movement campaigner. “Many of these politicians and pundits probably haven’t bothered to find out how their policies would actually affect such people.”

Pensioners who have paid into the national insurance system for the qualifying number of years benefit from the “S1” reciprocal healthcare rules if they retire in the EU, EEA countries or Switzerland.

The UK government stated in a little-publicised no-deal technical notice published this week: “An S1 certificate helps you and your dependents access healthcare in the EU/EEA country where you live. If you have an S1 certificate, it will be valid until 29 March 2019.

“After this date, the certificate may not be valid, depending on decisions by member states.”

The government says it is seeking bilateral deals with other EU countries on the continuation of healthcare but so far none have been arranged.

The notice advises retirees to investigate taking up private healthcare in the country they now reside, something that is likely to be come as shock to pensioners, especially in the Costa del Sol in Spain, where many have retired in order to make ends meet.

One 83-year-old pensioner in Spain, concerned that his healthcare was put at risk by the referendum, has said previously: “It is the skint ones who are at risk”.


The government has suggested worried pensioners research the state healthcare system in the country they now live and find out if they are eligible for treatment. But it warned that British citizens may not be able to get free treatment unless they have paid social security contributions.

There are 70,000 British pensioners in Spain, with another 44,000 in Ireland, 43,000 in France and 12,000 in Cyprus.

A senior civil servant in the Department of Health told a select committee in 2017 that “one of the advantages of the current arrangements was that it was cheaper for the government to reimburse Spain for treatment of pensioners there than have them return to the NHS for care”.

Spain charges an average of €3,500 per pensioner signed up to the S1, Ireland charges an average of €7,500 and the UK charges about €5,000, he said.

In total, the government paid out around £500 million – or £2,300 per pensioner – which he pointed out “was significantly lower than the cost of treating pensioners in the UK”. – Guardian

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